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City Manage s omce- M-31 <br />City of Santa Ana 20 CI* Center Plaza <br />}i Donation Request Santa�a„a, cg 92702 <br />I'714j 647.5200 <br />Name: <br />Roberto Figueroa for Brenda Rodriguez, ACH) <br />rtre; <br />Executive Direct or <br />ddreas: <br />2425 Channing Way, 8208 <br />—Phone: <br />Tax•Exempt Status: Is your organization a non-profit or public tax-exempt organization as <br />defined under Section 501(c)(J) of the Internal Revenue Code? <br />city, state, zip: <br />Berkeley, CA.94704 <br />619-254-9057 Ilf <br />Emag, <br />brodriguezaffordabfe-housing.org <br />Fax: <br />organization Information <br />Mail: City Manager's Office -M-31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Email: donation[equest@santaana.org <br />Fax: (714) 647.6954 <br />UC Berkeley Chicano Latino Alumni Association on behalf of Affordable Clearrl�ig� <br />House <br />I OR - <br />Council Meeting Date: I APRIL 17, 2018 <br />Tax•Exempt Status: Is your organization a non-profit or public tax-exempt organization as <br />defined under Section 501(c)(J) of the Internal Revenue Code? <br />elect One: <br />L. __I <br />®Y¢s <br />— <br />City Manager Signature: <br />I No <br />lPlyo, you will onlyqualify far a credit for City -related costs foryourrequest(i.e. permit fees, <br />taNttme,rerifalrate9farlaptitissorequipment,eta).CostsforCllyserviceswyaod8 <br />IfYes, <br />[47-1688249pproved, <br />credit may ormay not cover toll cost of requested Cifyservices <br />ax ID d: <br />III <br />o. <br />City Services Credit <br />mount Requested: '-��d[---�- <br />�X-^—,e� <br />Date Needed: i <br />Mayor/Councilm¢mher. Sarmiento <br />Direct Payment Amount 500�Ev�entOajte <br />Rnesed <br />Ejv¢n4Time; <br />bm I <br />Ii <br />Event . City, tar <br />Address, City, State, Zlp <br />_ <br />f <br />f— <br />C Icano Latino Alumni Association Chapter launch (Orange, County) - <br />Description of organize chapter to host yielding events for prospective high school a� <br />id commu <br />Event I Purpose: nity college students and to engage alumni• I <br />�I <br />Community Benefit: <br />ca emlo equity or un. errep resented stn ents,ln the Orange.Countyl <br />yea. <br />IAPPhoantSigrta`�e�, �, ,��)�sa,-r ar cr °w,�t '�i;'�`�4,' `Pate• ted`-" <br />.,� <br />Mail: City Manager's Office -M-31 <br />20 Civic Center Plaza <br />P.O. Box 1988 <br />Email: donation[equest@santaana.org <br />Fax: (714) 647.6954 <br />EXHIBIT I <br />29A-5 levised 01/0512017 <br />Donatian Request M: <br />I OR - <br />Council Meeting Date: I APRIL 17, 2018 <br />Eligibility Met: <br />YES 1 NO YES <br />Approved • Amount: I $500 <br />City Manager Signature: <br />— Date: <br />EXHIBIT I <br />29A-5 levised 01/0512017 <br />